Residential modifications and decline in physical function among community-dwelling older adults

Purpose: The purpose of this study is to quantify the effect of residential modification on decreasing risk of physical function decline in 2 years. Design: Cohort study using propensity scores method to control for baseline differences between individuals with residential modifications and those without residential modifications. Participants: Participants (N = 9,447) were from the Second Longitudinal Study on Aging, a nationally representative sample of the civilian noninstitutionalized population, aged 70 years and older in the United States at the time of baseline interview in 1994-1995. Methods: Participants self-reported residential modifications at baseline (e.g., railings, bathroom modifications). Decline in physical functioning was measured by comparing self-reported activities of daily living at baseline and at 2-year follow-up. Results: Compared with individuals without baseline modifications, a higher proportion of those with baseline modifications were aged 85 years and older (16% vs. 10%), used special aides (36% vs. 14%), and lived alone (40% vs. 31%). Using a weighted propensity score method, we found a modest decrease in risk of decline at Wave 2 for those with baseline modifications (risk difference = 3.1%). Respondents with a baseline residential modification were less likely to experience subsequent decline in functional ability (adjusted odds ratio = 0.88, 95% confidence interval = 0.79-0.97) after adjusting for quintile of propensity score in a survey-weighted regression model. Implications: Baseline modifications may be associated with reduced risk of decline among a nationally representative sample of older community-dwelling adults. Widespread adoption of residential modifications may reduce the overall population estimates of decline.